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Ordinance NO. 7035 February 19, 2008 “EXHIBIT D” AUGUSTA-RICHMOND COUNTY LOCAL SMALL BUSINESS OPPORTUNITY PROGRAM SUBCONTRACTOR/SUPPLIER UTILIZATION REPORT List all subcontractors/suppliers, including lower tiers, to be used on this project. PROJECT NAME PROJECT NO. BASE BID REPORT PERIOD FROM TO PROPOSED LSB UTILIZATION NAME OF SUB- CONTRACTOR/ SUPPLIER COMPANY NAME, ADDRESS, AND PHONE # CONTRACT AMOUNT TYPE OF WORK PERFORMED LSB BUSINESS (SEE CODE BELOW) YES/NO AMOUNT EARNED THIS PERIOD AMOUNT EARNED TO DATE PERCENTAGE OF TOTAL BID AMOUNT TOTALS Total CONTRACTOR: AUTHORIZED SIGNATURE DATE PAY REQUEST NO. PERCENTAGE OF TOTAL CONTRACT COMPLETED TO DATE